I don’t know why I continue to be shocked at the shenanigans pulled by some insurance companies.  Dr. Wes recently wrote Lab Wars and the Doctor-Patient Relationship, wherein he tells the tale of an insurer who is trying to dictate which lab facilities his patients use.  If I read the letter correctly, the insurer claims that the doctor is not supposed to be using his employer’s lab, even though the results feed directly into his EMR.  Instead, he’s to send patients somewhere else.  Somewhere that requires extra hoops – extra time – to obtain the patient’s lab results.  

Isn’t the goal to get the required data so that diagnosis & treatment decisions can be made in a timely manner? 

No, I guess not.  That’s the doctor’s goal.  The insurance company has different goals. 


I didn’t realize it mattered which lab is used.  I go wherever it’s most convenient for me. 

My PCP uses Lab A.  I can be drawn right there in his office, and he gets the results promptly.  If the lab tech isn’t there, I can go next door to a different doctor who also uses the same lab and have that tech draw me.  

My rheumatologist uses Lab B.  I can be drawn right in her office and the results show up in her EMR.  If there’s nobody in the office to do the blood draw (or the person looks at my arms and doesn’t even want to try), there’s another place in the same building that I can go to be drawn.  

This works great when I’m at the doctor’s office and labs are ordered.  However, hard as this may be to believe, I do not live at either doctor’s office.  I have a life outside of seeking medical care.  

red flags = labs


Have I mentioned that I live in the middle of nowhere?  It takes me nearly an hour to drive to my PCP’s  office, and another five minutes beyond there to my rheumatologist.  If I’m at a doctor’s office and blood work is ordered, I just pop into the lab and let them stick a needle in my arm.  No problem.  But if I’m at home with a lab slip, I’m not going to drive an hour for a two minute procedure, then turn around and drive another hour to get home.  

There is a different lab, not affiliated with either of the others, within reasonable driving distance of my house.  A bonus is that while the other places close at 4:30, this one is open until 8 p.m.  That’s where I go for lab work in between doctor’s appointments.  Lab C has never cared that the doctor’s order is written on a different lab’s form, and my rheumy is okay with those results not going straight to her EMR if it saves me two hours on the road.  

It never even occurred to me to be thankful that I can pick my own lab.  


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